| NPI | 1558701078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME163618) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 79523) |
| 207L00000X Anesthesiology (Licence: GA 006489) | |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2024-05-01 |