| NPI | 1720170764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 018227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 018227) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2017-04-03 |