| NPI | 1750377347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IN 01062207) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 35717) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 35717) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2016-09-07 |