| NPI | 1568477131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 45714) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2009013443) |
| 207L00000X Anesthesiology (Licence: IN 01062389A) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2021-11-01 |