| NPI | 1760596696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A87528) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 239118) |
| 208000000X Pediatrics (Licence: CA A87528) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2021-11-29 |