| NPI | 1962024430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 25493) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61535010) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2024-08-27 |