| NPI | 1972568459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX M8184) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX m8184) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL me86409) | |
| 207L00000X Anesthesiology (Licence: FL me86409) | |
| 207L00000X Anesthesiology (Licence: TX M8184) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: FL me86409) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-02-18 |