| NPI | 1013309277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD202307) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD.MD.61109997) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2023-12-19 |