| NPI | 1073578878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2014-01937) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F9104) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2015-08-10 |