| NPI | 1982852281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD 60201288) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO 49403) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2016-04-04 |