| NPI | 1689935140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: GA 78596) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 78596) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 78596) | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2025-04-08 |