| NPI | 1932167111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2005021802) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 232453) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KS 04-31385) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-09-18 |