| NPI | 1558362236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX E6515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 12296) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2013-03-18 |