| NPI | 1710373642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 83881) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A159908) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2026-02-25 |