| NPI | 1295792190 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX F6641) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F-6641) | 
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX F6641) | |
| Enumeration Date | 2006-04-26 | 
| Last Update Date | 2024-05-14 |