| NPI | 1659489508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: SC 14741) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 14741) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-01-13 |