| NPI | 1770774036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MT MED-PHYS-LIC-50477) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A99853) |
| 207L00000X Anesthesiology (Licence: SC 92750) | |
| 208600000X Surgery (Licence: CA A99853) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2025-07-17 |