| NPI | 1629002068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA G55841) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G55841) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2007-12-05 |