| NPI | 1851488977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL ME122647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN MD39192) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN MD39192) | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2015-02-04 |