| NPI | 1568462331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 14421) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01039758A) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2007-07-08 |