| NPI | 1912391079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: CT 65034) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A153811) |
| 207L00000X Anesthesiology (Licence: CT 65034) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MA 278483) | |
| Enumeration Date | 2015-03-26 |
| Last Update Date | 2023-02-07 |