| NPI | 1568752921 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD206341) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A125411) | 
| Enumeration Date | 2011-04-19 | 
| Last Update Date | 2024-05-15 |