| NPI | 1376745901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 4859) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58001158) |
| 207L00000X Anesthesiology (Licence: TX M9428) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-06-29 |