| NPI | 1871577171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 57081) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.26124) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2018-03-29 |