| NPI | 1427357664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60981506) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2016-00457) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2025-05-08 |