| NPI | 1174593396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60574567) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 46831) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2024-03-07 |