| NPI | 1316907330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA 20A11971) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101017413) |
| 208D00000X General Practice (Licence: IN 02002809A) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2012-11-16 |