| NPI | 1972823540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 327489) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 127666) |
| 207L00000X Anesthesiology (Licence: NY 327489) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 127666) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0101268307) | |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2024-08-28 |