| NPI | 1629110986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 44798) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01070386A) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2021-12-01 |