| NPI | 1134114374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35086952) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD069880L) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2025-01-16 |