| NPI | 1487973392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P8593) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0037934) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2014-08-05 |