| NPI | 1063573103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX Q1650) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q1650) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 058535) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2023-02-14 |