| NPI | 1306040993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX N2306) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP2-0025822) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-04-21 |