| NPI | 1144364076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME93031) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.123220) |
| 207L00000X Anesthesiology (Licence: KY 40897) | |
| 207L00000X Anesthesiology (Licence: IN 01073761A) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2022-01-25 |