| NPI | 1467749606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101277346) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D88820) |
| 207L00000X Anesthesiology (Licence: KY 60644) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 60644) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: VA 0101277346) | |
| 208000000X Pediatrics (Licence: MD D88820) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2025-08-04 |