| NPI | 1972968758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A178435) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61416657) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2024-10-08 |