| NPI | 1962543405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX G4959) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: OK 39407) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX G4959) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2023-10-09 |