| NPI | 1063932606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A196067) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NM MD2022-0354) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2026-01-05 |