| NPI | 1801976972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY TP775) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 32384) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 70808) | |
| 207L00000X Anesthesiology (Licence: TN 70808) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 70808) | |
| 207L00000X Anesthesiology (Licence: KY TP775) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KY TP775) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2026-01-05 |