| NPI | 1831763630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A199745) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 85947) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2025-06-12 |