| NPI | 1003268186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 39670) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC ll39670) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2021-09-08 |