| NPI | 1386604049 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A112190)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-44038)  | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A112190)  | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD D0076331)  | |
| Enumeration Date | 2006-03-27 | 
| Last Update Date | 2023-02-11 |