NPI | 1457354045 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: NM 2001-200) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 2001-200) |
207LP2900X Anesthesiology Pain Medicine (Licence: NM 2001-200) | |
207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME69110) | |
Enumeration Date | 2005-05-27 |
Last Update Date | 2025-03-13 |