| NPI | 1518022987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD600004076) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 231647) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2025-07-02 |