| NPI | 1669638961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2008-01125) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2008-01125) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2017-09-05 |