| NPI | 1548313133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 18415) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E1879) |
| 207L00000X Anesthesiology (Licence: TX G3630) | |
| 207V00000X Obstetrics & Gynecology (Licence: AR E1879) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2017-02-22 |