| NPI | 1659461127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M8724) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-3073) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX M8724) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2014-02-27 |