| NPI | 1841610094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD186102) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60762472) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2025-02-14 |