| NPI | 1497744304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 85616) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200200811) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2021-06-30 |