| NPI | 1508493313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13779240-1204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.031308) |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-06-20 |