| NPI | 1063533974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301086767) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N1890) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2013-08-26 |