| NPI | 1528327996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 20A17155) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 011506) |
| 207R00000X Internal Medicine (Licence: OH 011506) | |
| 207R00000X Internal Medicine (Licence: CA 20A17155) | |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2024-04-12 |