| NPI | 1407290588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A135190) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A135190) |
| 207L00000X Anesthesiology (Licence: WI 81028) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 81028) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2026-08-26 |