| NPI | 1306812417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 59086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 59086) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2007-08-13 |