| NPI | 1487814315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX V3326) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101020818) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2024-11-15 |