| NPI | 1669545513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-55106) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA a90764) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-06-02 |