| NPI | 1639490402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A118099) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX PIT # BP10038241) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2014-09-30 |