| NPI | 1811156532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60313189) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 0) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2023-10-06 |