| NPI | 1184647679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68243) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD28806) |
| 207L00000X Anesthesiology (Licence: WA MD00043066) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2021-03-31 |