| NPI | 1336700269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 111329) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2024-00984) |
| 207L00000X Anesthesiology (Licence: GA 111329) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NC 2024-00984) | |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2026-07-10 |