| NPI | 1013058536 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: IA MD-53382) | 
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MS 25782) | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX L6985) | |
| Enumeration Date | 2007-02-08 | 
| Last Update Date | 2024-11-22 |