| NPI | 1083608137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX N3897) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01061147) |
| 207L00000X Anesthesiology (Licence: MA 216227) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2022-06-22 |