| NPI | 1003016742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N2187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2187) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2011-08-03 |