| NPI | 1598754772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDRH.0053739) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 20790) |
| 207L00000X Anesthesiology (Licence: IN 01070742A) | |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2025-06-05 |