| NPI | 1730345547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N5379) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301091759) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2018-06-26 |