| NPI | 1528234192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60498236) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60498236) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2015-02-25 |