| NPI | 1639496508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX BP10036901) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.13640) |
| 207L00000X Anesthesiology (Licence: GA 049203) | |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2010-04-30 |