| NPI | 1508877036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME50735) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME50735) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2017-03-06 |