| NPI | 1699094383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 27464) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WV 27464) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 27464) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WV 27564) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2023-11-03 |