| NPI | 1467985069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA 61135016) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD203336) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2021-05-12 |