| NPI | 1750693099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101250393) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60878390) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60878390) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2024-02-19 |