| NPI | 1912024357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 73917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 073917) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2026-06-16 |