| NPI | 1942640768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61420193) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD61420193) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD61420193) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-07-30 |