| NPI | 1134147622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301047495) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301047495) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-10-15 |