| NPI | 1235199373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G53308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 10484) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2025-08-01 |