| NPI | 1568825644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.139289) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT210496) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2021-03-16 |