| NPI | 1609845197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX L8871) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35064121) |
| 207L00000X Anesthesiology (Licence: OH 350641210) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2019-10-18 |