| NPI | 1760537385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00016852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 16852) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-05-05 |