| NPI | 1609032226 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35.097832)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125-050753)  | 
| 207L00000X Anesthesiology (Licence: FL ME107303)  | |
| Enumeration Date | 2008-08-03 | 
| Last Update Date | 2018-10-15 |