| NPI | 1497496392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A208822) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX V4151) |
| 207L00000X Anesthesiology (Licence: WA MD.MD.70052312) | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-08-19 |