| NPI | 1609953850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TN 43972) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L7145) |
| 207L00000X Anesthesiology (Licence: TN MD0000043972) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2014-09-25 |