| NPI | 1194143313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 323707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036146350) |
| 207L00000X Anesthesiology (Licence: OH 1194143313) | |
| 207L00000X Anesthesiology (Licence: PA MD465814) | |
| 207L00000X Anesthesiology (Licence: OH 35.127286) | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2025-03-31 |