| NPI | 1982994877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2016006258) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KS 04-38700) |
| 207L00000X Anesthesiology (Licence: KS 04-38700) | |
| 207L00000X Anesthesiology (Licence: MO 2016006258) | |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2016-08-05 |