| NPI | 1659710986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C203622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11337788-1205) |
| 208600000X Surgery (Licence: MA 256054) | |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: CA C203622) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2025-12-09 |