| NPI | 1790016285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P7818) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP10034254) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2014-12-18 |