| NPI | 1992701361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N4852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 2312711) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-01-22 |