| NPI | 1093057721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD70058882) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 23200) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2026-02-23 |