| NPI | 1699232736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 75000113A) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: OK 26) |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2022-09-27 |