| NPI | 1851319792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD26988) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00033609) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-10-12 |