| NPI | 1932171873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.024626) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L4711) |
| Enumeration Date | 2006-02-05 |
| Last Update Date | 2018-10-18 |