| NPI | 1609936178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: WA MD00014958) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00014958) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2009-02-02 |