| NPI | 1578510863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q6725) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 151881) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2015-12-31 |