| NPI | 1558382341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00014891) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: WA MD00014891) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2008-02-05 |