| NPI | 1801889910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX E4351) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C37722) |
| 207L00000X Anesthesiology (Licence: CO 23736) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2008-11-18 |