| NPI | 1881954634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12106328-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 02004574A) |
| 207L00000X Anesthesiology (Licence: MT med-phys-lic-47547) | |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2021-03-23 |