| NPI | 1437360328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60028234) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G76943) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-11-12 |