| NPI | 1043296031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60102300) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 1037) |
| 207L00000X Anesthesiology (Licence: MI 5101026897) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-02-19 |