| NPI | 1285624395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 69221) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD 44074) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 69221) | |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2024-09-03 |