| NPI | 1760896484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NC 239680) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2014016502) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2018-08-20 |