| NPI | 1790967909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301092971) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 39518) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VT 042.0040047-COMP) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301092971) | |
| 207L00000X Anesthesiology (Licence: VT 042.0040047-COMP) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA 39518) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2026-05-13 |