| NPI | 1861420721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L0709) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L0709) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-12-28 |