| NPI | 1376617498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 186875) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 058157) |
| 208000000X Pediatrics (Licence: MI 058157) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MI 058157) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2023-05-15 |