| NPI | 1700303914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 1022385) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A179763) |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2025-11-03 |