| NPI | 1871098939 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A202296) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 31505201) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-08-06 |