| NPI | 1508989435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CT 044388) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 230300) |
| 207L00000X Anesthesiology (Licence: CT 044388) | |
| Enumeration Date | 2007-04-07 |
| Last Update Date | 2023-08-23 |