| NPI | 1598786055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 17470) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G65170) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA G65170) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-12-31 |