| NPI | 1982734695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 54790) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 54790) |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: WA 60003993) | |
| 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: WI 54790) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2019-05-07 |