| NPI | 1639188196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: TX F4181) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F4181) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2016-01-14 |