| NPI | 1518935774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA 31927) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD181952) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2025-12-08 |