| NPI | 1124553326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61267880) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 10990016-1205) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2022-08-01 |