| NPI | 1730507369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60930858) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R74908) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-08-14 |