| NPI | 1972677821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P6371) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX P6371) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2016-09-13 |