| NPI | 1205828340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C41640) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G5597) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2013-05-03 |