| NPI | 1174743348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60081740) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101016419) |
| 207L00000X Anesthesiology (Licence: CA 20A10834) | |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2020-03-03 |