| NPI | 1518373794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MI 4301105813) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301105813) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2019-07-10 |