| NPI | 1912954215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA G62817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G62817) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2025-09-11 |