| NPI | 1487649513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.065479) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD430885) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2019-08-02 |