| NPI | 1306306725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD.MD.61658980) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD214630) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-05-11 |