| NPI | 1518387075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60758853) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA DOL.OL.60473440) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2018-07-05 |