| NPI | 1215420336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0093863) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT215074) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2025-05-28 |