| NPI | 1619910445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MS 20921) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L0888) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-08-29 |