| NPI | 1992091334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO DR0055594) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR PG156007) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2016-11-21 |