| NPI | 1033311774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60134869) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL16597) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2010-05-19 |