| NPI | 1982897146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 46139) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 55599-20) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AZ 46139) | |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2024-09-09 |