| NPI | 1720124985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2017006893) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2017006893) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2021-11-16 |