| NPI | 1639582570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NH 20017) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 260407) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2022-12-13 |