| NPI | 1164715108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR.0053703) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 53703) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2020-07-16 |