| NPI | 1023163904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M7548) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 220599) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-05-10 |