| NPI | 1407037724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.202232) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010007581) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MO 2010007581) | |
| 207L00000X Anesthesiology (Licence: TX N9071) | |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2019-08-29 |