| NPI | 1639289580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 02240) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 02240) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-07-12 |