| NPI | 1295761229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A88819) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A88819) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A88819) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-02-25 |