| NPI | 1326128133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA 15288) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR 15428) |
| 207L00000X Anesthesiology (Licence: CA 40053) | |
| 207L00000X Anesthesiology (Licence: WA 24467) | |
| 207L00000X Anesthesiology (Licence: WA 25209) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-11-17 |