| NPI | 1811253263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 275137) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0015943) |
| 207L00000X Anesthesiology (Licence: NY 275137) | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2022-05-24 |