| NPI | 1568430882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C10009578) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 21680) |
| 207L00000X Anesthesiology (Licence: FL ME139306) | |
| 207L00000X Anesthesiology (Licence: PA MD441598) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME139306) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2021-03-01 |