| NPI | 1669605002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61121881) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD188226) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2021-08-24 |