| NPI | 1568677573 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A98699)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 43612)  | 
| Enumeration Date | 2007-05-12 | 
| Last Update Date | 2025-01-07 |