| NPI | 1629212923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P5556) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0034751) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2013-06-25 |