| NPI | 1013957752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60833231) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 48083) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-09-11 |