| NPI | 1760611941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60662918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195447) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2024-02-08 |