| NPI | 1215316047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0101269439) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 62325) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2026-08-05 |