| NPI | 1295777589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00047562) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD26424) |
| 174400000X Specialist | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-04-02 |