| NPI | 1770858615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD223781) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A191721) |
| Enumeration Date | 2012-03-10 |
| Last Update Date | 2025-09-05 |