| NPI | 1558557744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A96705) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 38479) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA 38479) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2015-10-13 |