| NPI | 1386801918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10037454) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.206292) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-06-28 |