| NPI | 1639517519 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-11407) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: MT MED-PHYS-LIC-128975) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: AR E11407) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2023-10-06 |