| NPI | 1548251234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00031358) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD31358) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-12-08 |