| NPI | 1003343997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA MD61170736) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD.MD.61170736) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2023-10-10 |