| NPI | 1851368567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60197779) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 24468) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2013-07-01 |