| NPI | 1053365932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX P2119) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01049228A) |
| 207L00000X Anesthesiology (Licence: VA 0101262432) | |
| 207L00000X Anesthesiology (Licence: IL 036100122) | |
| 207N00000X Dermatology (Licence: NC 2017-01463) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2025-06-02 |