| NPI | 1245328244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00039238) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 8775) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2013-01-30 |