| NPI | 1376608836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 18721) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 18721) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: NE 18721) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2013-02-22 |