| NPI | 1740522994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OK 39516) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60683442) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2022-08-01 |