| NPI | 1396064481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS017509) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 336060) |
| 207L00000X Anesthesiology (Licence: GA 076027) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: LA 336060) | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2024-01-19 |