NPI | 1700291051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD479755) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2017033860) |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2017033860) | |
Enumeration Date | 2014-06-25 |
Last Update Date | 2023-12-06 |