| NPI | 1992148506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDR.0001382) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301105554) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MI 4301105554) | |
| 208600000X Surgery (Licence: MA 2566820) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-01-24 |