| NPI | 1629147806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL U5380X) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME82742) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2016-11-11 |