| NPI | 1568412013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00027516) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: WA MD00027516) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-09 |