| NPI | 1013091164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA TR60264609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 98-01573) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-01-24 |