| NPI | 1134431604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A119726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt197116) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2015-07-27 |