| NPI | 1235168220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC MD17275) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 17275) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC MD17275) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2023-02-16 |