| NPI | 1063498699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-8924) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 18061) |
| 207L00000X Anesthesiology (Licence: MS 22931) | |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2025-05-20 |