| NPI | 1114061934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD28109) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00048122) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2012-10-12 |