| NPI | 1275744195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP00002194) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M3979) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX M3979) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA OP00002194) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-08-05 |