| NPI | 1508219239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301505299) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301110680) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301505299) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2023-11-01 |