NPI | 1235391897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA C202828) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT192913) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD449316) | |
Enumeration Date | 2008-06-25 |
Last Update Date | 2025-07-22 |