| NPI | 1700840170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: NM MD2022-0063) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A77329) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2022-05-03 |