| NPI | 1215192414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N2995) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 248458) |
| 207L00000X Anesthesiology (Licence: OK 4720) | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2009-07-23 |