| NPI | 1467795682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A135310) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 36780) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2026-09-15 |