| NPI | 1508108051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60770694) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60770694) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2018-07-03 |