| NPI | 1649765637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2018020004) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 65280) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2023-03-27 |