| NPI | 1295998961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD163003) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60652454) |
| 207L00000X Anesthesiology (Licence: MO 2011033889) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2022-02-04 |