| NPI | 1851352876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L0095) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101237941) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2011-10-24 |