| NPI | 1548584410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P0192) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 4512) |
| Enumeration Date | 2010-03-22 |
| Last Update Date | 2012-05-17 |