| NPI | 1922092840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 22795) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01055392A) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2022-11-23 |