NPI | 1073711958 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C1-0012461) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 282156) |
207L00000X Anesthesiology (Licence: PA MD450784) | |
Enumeration Date | 2007-07-03 |
Last Update Date | 2018-12-07 |