| NPI | 1801062062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX p6645) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 56866) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2021-01-28 |