NPI | 1376930891 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61053509) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 160746) |
Enumeration Date | 2015-04-22 |
Last Update Date | 2025-03-20 |