| NPI | 1912965807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G49739) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G49739) |
| 208000000X Pediatrics (Licence: CA G49739) | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2007-07-08 |