| NPI | 1821629353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61617352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 33736) |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2025-11-24 |