| NPI | 1699907485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 278846) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WI 47307-020) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA md00018770) | |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2019-05-28 |