| NPI | 1528179066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00017981) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: WA MD00017981) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-05-02 |