| NPI | 1730163007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: FL ME46722) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME0046722) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2012-07-26 |