| NPI | 1427031715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2022-00544) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME91611) |
| 207L00000X Anesthesiology (Licence: TN MD49728) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: WA MD 60077682) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2023-04-04 |