| NPI | 1487114195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP70048871) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC DO210001809) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2026-03-02 |