| NPI | 1457349532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 40858) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 020019) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2007-07-08 |