| NPI | 1255894325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX 1255894325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01089670A) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2023-07-19 |