| NPI | 1073692737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA LT000795) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA TR00039573) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2018-01-18 |