| NPI | 1225022502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A50304) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 102925-875) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2025-08-27 |