| NPI | 1164718623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2024010348) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2024010348) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2024-07-02 |