| NPI | 1003029323 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 1149) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: SC 1149) | 
| 207L00000X Anesthesiology (Licence: OH 34008457) | |
| Enumeration Date | 2007-05-07 | 
| Last Update Date | 2021-08-11 |