| NPI | 1982683876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61489808) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301060283) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2024-01-12 |