| NPI | 1518199140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301094709) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301094709) |
| Enumeration Date | 2009-08-15 |
| Last Update Date | 2022-11-04 |