| NPI | 1336120260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 30200) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00030603) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2022-10-18 |