| NPI | 1255380523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA MD-44120) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101239375) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NM MD2012-0129) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME76270) | |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2017-03-07 |