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 |