| NPI | 1962611327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: VA 0101283866) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OK 30998) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-01-02 |