| NPI | 1821265430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD162049) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA 60662859) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2023-03-01 |