| NPI | 1205823978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SD 9064) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 13859) |
| 208000000X Pediatrics (Licence: SD 9064) | |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2023-12-28 |