| NPI | 1528322294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60647340) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL UO3053) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2023-01-30 |