| NPI | 1497076343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NE 26475) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101266771) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0101266771) | |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2025-05-12 |