| NPI | 1013908565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 31955) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M3638) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2007-11-13 |