| NPI | 1881604759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA md00017318) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA md00017318) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA md00017318) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-06-18 |