| NPI | 1700051398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: VA 0101255601) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101255601) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2023-06-22 |