| NPI | 1790731933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 11396) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 17681) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-05-14 |