| NPI | 1588055230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA ML61163523) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A165729) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2024-04-01 |