NPI | 1982632592 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME102582) |
Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AR E5990) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN 10274) | |
Enumeration Date | 2006-06-30 |
Last Update Date | 2018-10-17 |