| NPI | 1770107278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A202922) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R11893) |
| 207L00000X Anesthesiology (Licence: MI 4301511080) | |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2025-07-29 |