| NPI | 1972820835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P8698) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX BP1-0037937) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2014-04-21 |