| NPI | 1205036282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 37780) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M6784) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-06-15 |