| NPI | 1962095752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 34.018171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OP70035472) |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2026-03-02 |