| NPI | 1194352765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 68754) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 0000068754) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2026-04-01 |