| NPI | 1265428080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 18609) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35070160) |
| 207L00000X Anesthesiology (Licence: KY 26581) | |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2022-08-24 |