| NPI | 1780647594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 1151) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J5202) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2008-08-05 |