| NPI | 1699791574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00048911) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: HI MD14600) |
| 207L00000X Anesthesiology (Licence: OR MD25021) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-04-08 |