| NPI | 1912979733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology Critical Care Medicine (Licence: TX K4261) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX K4261) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2009-08-27 |