| NPI | 1679863633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 23817) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 67910) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2023-09-20 |