| NPI | 1760693444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA 60203919) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60203919) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2018-03-29 |