| NPI | 1073787115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TX P3945) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.097394) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2012-10-10 |