| NPI | 1760808141 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AR E-11281) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 5777) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2021-01-01 |