| NPI | 1942386685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA TR00040354) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA TR00040354) | 
| Enumeration Date | 2006-10-27 | 
| Last Update Date | 2012-03-07 |