| NPI | 1639465925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 57106) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA MT200556) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-08-09 |