| NPI | 1215274287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0102203878) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102203878) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2024-11-01 |