| NPI | 1851584759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WV 3172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 3172) |
| 207L00000X Anesthesiology (Licence: PA OT010803) | |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2022-07-21 |