| NPI | 1861739435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A124461) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A124461) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2018-01-25 |