| NPI | 1760645824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P3053) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 261585) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2016-01-14 |