| NPI | 1568486330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M9978) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX M9978) |
| 208000000X Pediatrics (Licence: LA 025547) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-03-19 |