| NPI | 1578785507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX P2588) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101247377) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2021-05-05 |