| NPI | 1558673525 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A125640)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R72252)  | 
| Enumeration Date | 2010-07-07 | 
| Last Update Date | 2024-10-03 |