| NPI | 1013183631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2011008545) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 05181) |
| 207L00000X Anesthesiology (Licence: SC 1198) | |
| 207L00000X Anesthesiology (Licence: NE 2272) | |
| 207L00000X Anesthesiology (Licence: OH 34.009378) | |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2021-05-05 |