| NPI | 1104026012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A 12308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX P1218) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2016-02-11 |