| NPI | 1164494969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.130986) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 181054) |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2020-12-16 |