| NPI | 1679509350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA G57589) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G57589) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2007-12-05 |