| NPI | 1033550819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60637087) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS KS440687) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2024-08-27 |