| NPI | 1548848740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 77487-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 77487-020) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2026-09-21 |