| NPI | 1902330558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA OP61502178) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0102206727) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2024-01-19 |