| NPI | 1134167943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00018370) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD211415) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2023-04-13 |