NPI | 1235559782 |
---|---|
Former Name | TRAVIS LEE REECE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A155840) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A155840) |
Enumeration Date | 2014-04-23 |
Last Update Date | 2024-04-11 |