| NPI | 1780875971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N4682) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0028923) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2015-01-29 |