| NPI | 1972709095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: TX N2106) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N2106) |
| 207L00000X Anesthesiology (Licence: CA A86469) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2021-05-26 |