| NPI | 1992971063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C181331) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60888861) |
| 207L00000X Anesthesiology (Licence: NM MD2008-0165) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2022-11-08 |