| NPI | 1740721943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD049006) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301508689) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301508689) | |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2023-05-01 |