| NPI | 1750548756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX M8130) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.201187) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2011-06-17 |