| NPI | 1851977896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD223812) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD.MD70155062) |
| Enumeration Date | 2021-03-21 |
| Last Update Date | 2026-09-10 |