| NPI | 1154307791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 216143) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A876800) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2024-04-22 |