| NPI | 1659877496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61365547) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D95707) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-08-02 |