| NPI | 1811004807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN DO1703) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: UT 12042620) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-09-22 |