| NPI | 1275532491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 31065) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35055162) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2024-06-27 |