| NPI | 1144304015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00047995) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC T-01771) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2015-04-08 |