| NPI | 1457354045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| 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 |