| NPI | 1558315705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00044849) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD25411) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2009-04-02 |