| NPI | 1518123348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A11152) |
| 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-34409) | |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2015-02-26 |