| NPI | 1295078871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 110716) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA A135486) | |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2026-05-27 |