| NPI | 1396750725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD 00048897) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT 92143) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-02-03 |