| NPI | 1215028220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME92740) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME92740) |
| 208000000X Pediatrics (Licence: FL ME92740) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2011-11-14 |