| NPI | 1083611651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 17205) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 017205) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2023-06-01 |