| NPI | 1033190707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00048512) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101044767) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2009-01-21 |