| NPI | 1548417413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N8792) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX bp10029888) |
| Enumeration Date | 2008-08-22 |
| Last Update Date | 2014-01-08 |