| NPI | 1215389861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2018016658) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2018016658) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2024-04-25 |