| NPI | 1346250776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N3121) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301087965) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2009-07-16 |