| NPI | 1871688952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX K0591) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD-058493-L) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-07-29 |