| NPI | 1336728880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A197997) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 1336728880) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2025-09-04 |