| NPI | 1225004260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CO 38917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 38917) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2014-06-20 |