| NPI | 1760816144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD197386) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61065183) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2026-04-08 |