| NPI | 1619184777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q5357) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX Q5357) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-09-25 |