| NPI | 1124116199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX G2280) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G2280) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2021-04-09 |