| NPI | 1295773737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60744732) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD H0062904) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD H0062904) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MD DH0062904) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: WA OP60744732) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2022-07-21 |