| NPI | 1801020599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A108011) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 235258) |
| 207L00000X Anesthesiology (Licence: TX TBD) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2009-08-20 |