| NPI | 1154697175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 69125) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 69125) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2024-03-11 |