| NPI | 1962446757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 43311) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 24148) |
| 174400000X Specialist (Licence: TN 43311) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2009-08-05 |