| NPI | 1457526238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 49823) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 284711) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2023-06-29 |