| NPI | 1649552910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 59585) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60631998) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2022-03-23 |