| NPI | 1558658385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A119588) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A119588) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2022-07-21 |