| NPI | 1932367125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 10010) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX K8663) |
| 207L00000X Anesthesiology (Licence: CO 42138) | |
| Enumeration Date | 2008-05-25 |
| Last Update Date | 2011-05-13 |