| NPI | 1558894758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A160137) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A160137) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2026-02-24 |