| NPI | 1326027863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L3221) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L3221) |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2017-01-26 |