| NPI | 1750378550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00026407) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD24618) |
| 207L00000X Anesthesiology (Licence: CA G58230) | |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2011-12-05 |