| NPI | 1710936661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 28799) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01042510) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2023-03-01 |