| NPI | 1235494493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME141381) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME141381) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2021-06-04 |