| NPI | 1881684926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00028036) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AK 127388) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2025-10-22 |