| NPI | 1790882660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX M7871) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 02002831A) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-10-13 |