| NPI | 1184859233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2014018802) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 2014018802) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: KS 05-37357) | |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2022-02-15 |