| NPI | 1235540360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A143362) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61638854) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2025-06-20 |