| NPI | 1124216510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N6279) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP3-0029858) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2015-03-20 |