| NPI | 1730742289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61528482) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A181487) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD61528482) | |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2024-11-08 |