| NPI | 1912240607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 54375) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 321248) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2019037032) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 321248) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2023-02-08 |