| NPI | 1467630566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR DO28607) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OR DO28607) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD 467800555) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2018-10-19 |