| NPI | 1710449913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A205325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2026-03726) |
| 207L00000X Anesthesiology (Licence: WA MD61432523) | |
| 207L00000X Anesthesiology (Licence: IL 036176542) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2026-07-10 |