| NPI | 1588839690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2018-02142) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101248810) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD039585) | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2024-09-23 |