| NPI | 1619120532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 44479) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN) |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2020-10-27 |