| NPI | 1063088615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A24090) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 12836) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2025-12-08 |