| NPI | 1124109327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N2982) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC LL279944) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-12-30 |