| NPI | 1043330574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T8732) |
| Additional Taxonomies | 174400000X Specialist |
| 207L00000X Anesthesiology (Licence: WA MD00047841) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2023-05-10 |