| NPI | 1245539543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301509942) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MI 4301509942) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2023-10-20 |