| NPI | 1689916694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX R9370) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 57029061) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2019-02-13 |