| NPI | 1689315624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A193750) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 193750) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-08-06 |