| NPI | 1043242266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NM MD2006-0533) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00026206) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-03-31 |