| NPI | 1033265616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 48619) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301089582) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301089582) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-04-01 |