| NPI | 1457700098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61041565) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10562) |
| Enumeration Date | 2016-06-05 |
| Last Update Date | 2023-05-11 |