| NPI | 1588879944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: OH 67.000131) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: GA 1564) |
| 367H00000X Anesthesiologist Assistant (Licence: GA 005166) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-03-04 |