| NPI | 1912917444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 024439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M0955) |
| 207L00000X Anesthesiology (Licence: KY 39679) | |
| 207L00000X Anesthesiology (Licence: NM 2003-0560) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-11-05 |