| NPI | 1891775243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60221650) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 220729) |
| 207L00000X Anesthesiology (Licence: MI 4301084822) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2025-05-08 |