| NPI | 1225273113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA md00015610) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101239450) |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2009-04-22 |