| NPI | 1861627739 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD D84892) | 
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DC MD041231) | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME119865) | |
| Enumeration Date | 2009-05-21 | 
| Last Update Date | 2023-05-09 |