| NPI | 1881915551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q0484) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245134) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2014-09-29 |