| NPI | 1598025876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX T3662) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.127840) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2024-07-03 |