| NPI | 1205011103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX N4704) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N4704) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2024-04-09 |