| NPI | 1568677334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME 98254) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD 430173) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-10-11 |