| NPI | 1801840939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L3730) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD417510) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2009-03-03 |