| NPI | 1104056803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A111904) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A111904) |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2024-04-11 |