| NPI | 1598931958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.093602) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA MD51537) |
| 207L00000X Anesthesiology (Licence: WI 63406-20) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2023-10-04 |