| NPI | 1831229632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA 108203) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD428658) |
| 207L00000X Anesthesiology (Licence: AZ 36499) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2021-12-01 |