| NPI | 1750301339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A85860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME161344) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-04-11 |