| NPI | 1558354993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A81822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD456369) |
| 207L00000X Anesthesiology (Licence: MI 4301113241) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: PA MD456369) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2023-01-30 |