| NPI | 1245492800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60273276) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT190162) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2015-05-04 |