| NPI | 1033154240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A67411) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 76098) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2025-03-26 |