| NPI | 1083788616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 38351) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 38351) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2023-08-31 |