| NPI | 1134446396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P9294) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10037930) |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2016-03-23 |