| NPI | 1477787018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD190570) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2014-00383) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA MD60375336) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2019-08-02 |