| NPI | 1982040036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 56540) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R73776) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2019-11-13 |