| NPI | 1023092145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00045090) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 307187) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2018-08-30 |