| NPI | 1174766067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD464749) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.097537) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2020-10-03 |