| NPI | 1801949847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 44185) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 225895) |
| 207L00000X Anesthesiology (Licence: TN 44185) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2022-01-11 |