| NPI | 1225085665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR 18515) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00030566) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2008-02-02 |