| NPI | 1689843195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP60279606) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58002268) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2023-11-22 |