| NPI | 1770692410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00047821) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA ML20007717) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2021-06-02 |