| NPI | 1619331949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A167328) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61031212) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2023-06-13 |