| NPI | 1528149275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N6196) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AR E-3832) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2014-10-14 |