| NPI | 1407800758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00041068) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD00041068) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-21 |