| NPI | 1487801858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX F2917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML60006960) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2013-07-12 |