| NPI | 1821363102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60912003) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX Q6629) |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2019-04-22 |