| NPI | 1891774154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX H4156) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TX H4156) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2021-02-11 |