| NPI | 1346261286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MO 109442) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 109442) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2018-01-29 |