| NPI | 1780621268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C196713) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301072778) |
| 207L00000X Anesthesiology (Licence: NV 10242) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2025-01-17 |