| NPI | 1225419146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NV 19483) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 19483) | 
| Enumeration Date | 2015-06-16 | 
| Last Update Date | 2022-06-14 |