| NPI | 1689561763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA SPI889) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: CA SPI889) |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2026-08-18 |