| NPI | 1912046905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N2647) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 2005-0252) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2013-05-15 |