| NPI | 1558864769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 62932) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0104824) |
| 207L00000X Anesthesiology (Licence: CA A154730) | |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2025-09-10 |