| NPI | 1548378052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX J3301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J3301) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2012-04-03 |