| NPI | 1154678035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-10094) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301101059) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2025-05-27 |