| 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 |