| NPI | 1356874010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.144869) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DC MD047882) |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2022-05-12 |