| NPI | 1508243536 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 73067) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 54239) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2025-01-22 |