| NPI | 1699856849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 216693) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 216693) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-10-04 |