| NPI | 1558393132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME117500) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D60334) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D60334) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D60334) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: DC ME117500) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-01-23 |