| NPI | 1033107339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L3303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L3303) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2011-02-14 |