| NPI | 1073197737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 20A24360) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL U07847) |
| 207L00000X Anesthesiology (Licence: FL OS20484) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2025-11-09 |