| NPI | 1760845689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV MD474021) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD474021) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MT210801) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-10-18 |