| NPI | 1972594638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 40583) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD40583) |
| 207L00000X Anesthesiology (Licence: ND PT20723) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2024-02-13 |