| NPI | 1225577950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP61607232) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP61607232) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2025-02-22 |