| NPI | 1922083450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D42992) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 252446) |
| 207L00000X Anesthesiology (Licence: GU M-2261) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MA 252446) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MA 252446) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2023-04-07 |