| NPI | 1699771634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G158086) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 24324) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2025-06-27 |