| NPI | 1194793752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: MA 46178) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MA 46178) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |