| NPI | 1134110414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 76090) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 76090) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2007-12-10 |