| NPI | 1356579726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 67450) |
| Additional Taxonomies | 208VP0000X (Licence: WI 67450) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 67450) | |
| 208000000X Pediatrics (Licence: MO 2010027316) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2021-08-10 |