| NPI | 1972618247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR.0041811) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 41811) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-11-02 |