| NPI | 1275512170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101012154) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OP70066372) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2025-12-29 |