| NPI | 1679213060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 22043) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME DO4343) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2026-10-05 |