| NPI | 1467455725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L5650) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L5650) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-02-20 |