| NPI | 1659586402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M3677) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 239778) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2009-06-01 |