| NPI | 1508809716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60140022) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 1577) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2021-08-03 |