| NPI | 1720178122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61145313) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01061732A) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2023-11-03 |