| NPI | 1588768808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME101788) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME101788) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2012-08-15 |