| NPI | 1023894680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA LT001046) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A205264) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2026-01-16 |