| NPI | 1457325367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60621776) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD24325) |
| 207L00000X Anesthesiology (Licence: AZ 38092) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-09-16 |