| NPI | 1932134251 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA G72617) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G72617) | 
| Enumeration Date | 2006-07-12 | 
| Last Update Date | 2009-10-02 |