| NPI | 1780669507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D 0037252) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX F 2079) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2008-03-13 |