NPI | 1326239807 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A123343) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301090638) |
207L00000X Anesthesiology (Licence: MA 235685) | |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OH 35.098076) | |
207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NY 274471) | |
Enumeration Date | 2007-08-08 |
Last Update Date | 2014-05-02 |