| NPI | 1730370933 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N8875) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0028925) | 
| Enumeration Date | 2007-08-05 | 
| Last Update Date | 2011-06-14 |