| NPI | 1871173153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2026-03043) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA 20A24131) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2026-09-11 |