| NPI | 1760656250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301102510) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA C194646) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: MI 4301102510) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2024-06-04 |