| NPI | 1164483152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 57943) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MA 57943) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2007-08-13 |