| NPI | 1750348686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX k5472) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX K5672) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2009-07-10 |