| NPI | 1790314805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A199804) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 73243) |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2026-06-29 |