| NPI | 1568406114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G87219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C10008527) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C10008527) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-01-15 |