| NPI | 1912931239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME110456) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0063378) |
| 207L00000X Anesthesiology (Licence: CA C168072) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2021-07-19 |