| NPI | 1114973476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PR 11489) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PR 11489) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-02-14 |