| NPI | 1508244450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 74465) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD-47360) |
| 207L00000X Anesthesiology (Licence: MI 4301505791) | |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2025-08-20 |