| NPI | 1770961674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX R6947) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP10053063) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2023-11-06 |