| NPI | 1255652715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2013005281) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD440022) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2013-07-02 |