| NPI | 1760833933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MN 67069) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 008737) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2022-06-27 |