| NPI | 1619293123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA MD60763662) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60763662) |
| 207L00000X Anesthesiology (Licence: NC 2018-00832) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: IL pending) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2023-01-12 |