| NPI | 1134325947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 47286) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 059153) |
| 207L00000X Anesthesiology (Licence: IA MD-55313) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2025-08-06 |