| NPI | 1922257500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ID O-1308) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 02008840A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2026-04-15 |