| NPI | 1023351343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60741435) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML 60374825) |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2022-07-21 |