| NPI | 1891994620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD60070605) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND RL10298) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2021-08-26 |