| NPI | 1104853365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K8943) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J4471) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2008-04-17 |