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 |