| NPI | 1376636464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX H9232) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H9232) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-04-26 |