| NPI | 1306023569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60165836) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A97874) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2014-12-02 |