| NPI | 1891806162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 169252-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M-4600) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |