| NPI | 1306033162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX P5060) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A92282) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2013-05-07 |