| NPI | 1104659150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A198641) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A198641) |
| Enumeration Date | 2024-08-24 |
| Last Update Date | 2025-08-01 |