| NPI | 1881954634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12106328-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MT med-phys-lic-47547) |
| 207L00000X Anesthesiology (Licence: IN 02004574A) | |
| 207L00000X Anesthesiology (Licence: OR DO222639) | |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2025-01-16 |