| NPI | 1578797163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 57307) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60456394) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: WA MD60456394) | |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: AZ 57307) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2020-10-01 |