| NPI | 1730316837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 46508) |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MT224970) |
| 208D00000X General Practice (Licence: TN 46508) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2023-09-21 |