| NPI | 1164983508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 74316) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 11885653-1205) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-07-24 |