NPI | 1821352212 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD d92226) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A136870) |
208000000X Pediatrics (Licence: NC 2018-01154) | |
Enumeration Date | 2012-06-29 |
Last Update Date | 2021-08-03 |