| NPI | 1659727600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: TX T9642) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A172754) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2023-04-26 |