| NPI | 1184845323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP61385679) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS10724) |
| 207L00000X Anesthesiology (Licence: CA 20A13369) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-05-19 |