| NPI | 1205268497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 2021027441) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: KS 04-44617) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2022-01-22 |