| NPI | 1558326157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX E5045) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G30464) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2016-06-30 |