| NPI | 1639326507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 254686) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 70478) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 254686) | |
| 208000000X Pediatrics (Licence: NY 249048) | |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2024-07-02 |