| NPI | 1518128644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60539006) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A116096) |
| 207L00000X Anesthesiology (Licence: OR MD166680) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2015-05-19 |