| NPI | 1689765299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KY 34627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 34627) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-06-04 |