| NPI | 1316391089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA 61149344) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 290717) |
| 207L00000X Anesthesiology (Licence: IL 036.150840) | |
| 207L00000X Anesthesiology (Licence: OR 204041) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2021-07-06 |