| NPI | 1720199698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD 60082201) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD 60082201) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-07-08 |