| NPI | 1437589306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS018564) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PR OS018564) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2024-05-21 |