| NPI | 1104358308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: AZ 71822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2022017517) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 2022017517) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-09-11 |