| NPI | 1255542932 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A113057) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R7817) | 
| Enumeration Date | 2007-05-24 | 
| Last Update Date | 2025-01-14 |