| 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 |