| NPI | 1104081207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 72468-20) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301096789) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2022-10-07 |