| NPI | 1760566673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P6424) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 97-00288) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-07-25 |