| NPI | 1992958540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60152419) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60152419) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2014-12-30 |