| NPI | 1467863985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 93734) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 93734) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR.0063407) | |
| 207L00000X Anesthesiology (Licence: SC 93734) | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2025-10-29 |