| NPI | 1316916737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 53088) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 53088) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-08-20 |