| NPI | 1831302645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60079206) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 371313-1204) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2011-12-29 |