| NPI | 1679507909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A91310) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 232807) |
| 207L00000X Anesthesiology (Licence: AZ 76943) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-06-02 |