| NPI | 1457649865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A141102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09871100) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A141102) | |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2024-09-09 |