| NPI | 1700327061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 67086) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A158148) |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2022-09-13 |