| NPI | 1184010258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX U9007) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: MA 278748) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MA 278748) | |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-08-07 |