| NPI | 1093923997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60305917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101239158) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2018-12-14 |