| NPI | 1184706608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO 49491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OL20000111) |
| 207L00000X Anesthesiology (Licence: WA OP60150344) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2019-03-02 |