| NPI | 1871575670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 042549) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CT 042549) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-08-23 |