| NPI | 1922090133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61276491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10907) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2022-11-02 |