| NPI | 1821139510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OK 27000) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H8898) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX H8898) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2022-06-01 |