| NPI | 1679910277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: KY 04344) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: KY TP508) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2023-07-12 |