| NPI | 1114932076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD00027010) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 27010) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2018-05-04 |