| NPI | 1669883377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0102204370) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102204370) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: HI DOS-1986) | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2024-03-08 |