| NPI | 1508989377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A74822) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A74822) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2012-02-22 |