| NPI | 1861460149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 80704) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 80704) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2007-08-20 |