| NPI | 1881671642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX H1362) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX H1362) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2009-08-11 |