| NPI | 1215498662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61430453) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-132002) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2024-08-20 |