| NPI | 1366838518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A172817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD61690875) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-07-24 |