| NPI | 1295748077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101275779) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35085492) |
| 207L00000X Anesthesiology (Licence: PA MD429931) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-08-29 |