| NPI | 1285907246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY P00861) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 012620) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2022-01-09 |