| NPI | 1306833108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00032673) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD17815) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2024-01-08 |