| NPI | 1528299757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60343105) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60343105) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2015-01-14 |