| NPI | 1801823976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL me166858) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 1020042) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 1020042) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2024-09-18 |