| NPI | 1174634745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 12352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60094851) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2011-05-12 |