| NPI | 1639378557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60173980) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60173980) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60173980) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2021-05-18 |