| NPI | 1205079779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 1015892) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 51721) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2023-07-18 |