| NPI | 1972659589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR.0045760) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 45760) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2018-11-02 |