| NPI | 1467495374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OR MD161240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G81592) |
| 207L00000X Anesthesiology (Licence: FL ME95492) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 52778-20) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-02-22 |