| NPI | 1518907849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60240914) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX M3569) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-06-22 |