| NPI | 1487696720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.081325) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD418770) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-12-17 |