| NPI | 1245224203 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 19643)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01048387A)  | 
| Enumeration Date | 2005-09-07 | 
| Last Update Date | 2007-10-10 |