| NPI | 1083916506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 24246) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 20246-020) |
| Enumeration Date | 2010-12-04 |
| Last Update Date | 2018-10-05 |