| NPI | 1750356846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY C2379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY C2379) |
| 207L00000X Anesthesiology (Licence: NV 11420) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-05-03 |