| NPI | 1124299771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR 91006605RN) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR 091006605CRNA) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |