| NPI | 1912018920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: LA MD.202836) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML20007881) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-10-13 |