| NPI | 1356377352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA OS014936) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS9780) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2009-11-16 |