| NPI | 1558641464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 01073766A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA MT 200476) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2015-06-24 |