| NPI | 1942311840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G70413) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX N8913) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-05-02 |