| NPI | 1487017786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C206960) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL 22872) |
| 207L00000X Anesthesiology (Licence: ME MD24010) | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2026-06-23 |