| NPI | 1447526801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA 60741857) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 276253) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2017-07-31 |