| NPI | 1033652938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 66571) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OP60959342) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2020-09-14 |