| NPI | 1619219193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2022015524) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9410101) |
| 208000000X Pediatrics (Licence: OH 34012359) | |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2022-07-21 |