| NPI | 1548370463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: OR MD27400) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G80144) |
| 207L00000X Anesthesiology (Licence: OR MD27400) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2026-06-05 |