| NPI | 1669883443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60928566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD187302) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2019-08-29 |