| NPI | 1619237484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 140860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 55367) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2026-01-15 |