| NPI | 1518983238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD00047798) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.085329) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-12-09 |