| NPI | 1528350279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME146519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301098547) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2025-01-20 |