| NPI | 1982648523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: SC 12766) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 12766) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-05-06 |