| NPI | 1194386979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 1013070) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2023000516) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2025-06-02 |