| NPI | 1164491379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 88397) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 58651) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A119480) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2022-09-22 |