| NPI | 1467635409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX S2200) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S2200) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX S2200) | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2019-09-03 |