| NPI | 1811981509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA 41289) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L6618) |
| 207L00000X Anesthesiology (Licence: CA G76518) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2013-10-16 |