| NPI | 1629313895 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-16138)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301101808)  | 
| Enumeration Date | 2012-11-29 | 
| Last Update Date | 2023-04-07 |