| NPI | 1316381718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA ML60380367) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60868964) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2019-09-10 |