| NPI | 1639610066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A156858) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD203480) |
| Enumeration Date | 2017-03-18 |
| Last Update Date | 2025-11-18 |