| NPI | 1659545150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME104132) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 239229) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2016-11-11 |