| NPI | 1184611998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00029015) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD16828) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2013-02-13 |