| NPI | 1770792244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301078140) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301078140) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2023-11-09 |