| NPI | 1023061447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MS 21068) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J6988) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-04-29 |