| NPI | 1932294972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 29058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G73722) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-06-13 |