| NPI | 1831266352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD482663) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 36927) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-02-12 |