| NPI | 1558700245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME142353) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0059459) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2019-12-26 |