| NPI | 1801922547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MA 239306) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 239306) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2010-11-07 |