| NPI | 1578543682 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 19132) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 19132) | 
| Enumeration Date | 2006-01-17 | 
| Last Update Date | 2022-12-13 |