| NPI | 1093747651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 42993) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME75219) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX M3992) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-10-15 |