| NPI | 1902848088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: UT 6559721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46304) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-03-07 |