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 |