| NPI | 1629572011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A163365) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A163365) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2023-07-31 |