| NPI | 1891054037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 10270107-1204) |
| Additional Taxonomies | 207LP3000X Anesthesiology Pediatric Anesthesiology (Licence: UT 10270107-1204) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2017-03-22 |