| NPI | 1366487035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.135977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD058957L) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2022-09-09 |