| NPI | 1245227461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 30389)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01045964A)  | 
| Enumeration Date | 2005-10-03 | 
| Last Update Date | 2023-04-26 |