| NPI | 1124239140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 49301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N0025) |
| 207L00000X Anesthesiology (Licence: LA MD200245) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-07-01 |