| NPI | 1376784066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD456626) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: DC MD040537) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: PA MD456626) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TN MD49600) | |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2017-03-31 |