| NPI | 1215161807 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2024019541) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 42188) | 
| 207L00000X Anesthesiology (Licence: MO 2024019541) | |
| Enumeration Date | 2009-05-11 | 
| Last Update Date | 2025-07-23 |