| NPI | 1538288717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301084272) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301084272) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-27 |