| NPI | 1669660445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT MED-PHYS-LIC-790572) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OL20000129) |
| 207L00000X Anesthesiology (Licence: WA OP60128535) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2019-05-10 |