| NPI | 1023512985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A165040) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA a165040) |
| 207L00000X Anesthesiology (Licence: UT 12420020-1205) | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2024-08-12 |