| NPI | 1407851074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 21465) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 021465) |
| 207L00000X Anesthesiology (Licence: KY 24604) | |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2015-11-24 |