| NPI | 1932215464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 13810) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 02001248A) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2018-11-09 |