| NPI | 1942682935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME165492) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 70832-20) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2025-04-30 |