| NPI | 1588306161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 77369) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 74571) |
| 207L00000X Anesthesiology (Licence: MN 33128) | |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2026-07-08 |