| NPI | 1275777534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 25760) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 272934) |
| 207L00000X Anesthesiology (Licence: OH 57012451) | |
| Enumeration Date | 2009-04-29 |
| Last Update Date | 2023-06-07 |