| NPI | 1306071659 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P6288) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10033748) | 
| Enumeration Date | 2009-05-15 | 
| Last Update Date | 2013-06-26 |