| NPI | 1154400851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AK 161463) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35 091520) |
| 207L00000X Anesthesiology (Licence: TX J3291) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-07-23 |