| NPI | 1750471322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME136212) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E2830) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2019-01-24 |