| NPI | 1326497199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 05028) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL39380) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY TP045) | |
| Enumeration Date | 2016-06-12 |
| Last Update Date | 2021-07-08 |