| NPI | 1184037863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2024028587) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KS 04-49483) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2025-12-05 |