| NPI | 1699716282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G128352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD60854517) |
| 207L00000X Anesthesiology (Licence: OR MD14731) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2025-11-17 |