| NPI | 1902833742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX L4406) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME85392) |
| 207L00000X Anesthesiology (Licence: TX L4406) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2012-04-04 |