| NPI | 1447433651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00049439) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2006-00778) |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2014-09-30 |