| NPI | 1023116415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX N8124) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G43753) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2014-02-20 |