| NPI | 1326038456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MA 73198) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 73198) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2025-09-11 |