| NPI | 1124778550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 02008413A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R3803) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2026-06-04 |