| NPI | 1528265659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY C2499) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 34086) |
| 207L00000X Anesthesiology (Licence: MA 233412) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-07-25 |