| NPI | 1780258434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 290705) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 283096) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2021-12-15 |