| NPI | 1508063397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2002019373) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA 20A11613) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: KS 05-35589) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2012-08-01 |