| NPI | 1245406388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2015-01854) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60285098) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2022-01-07 |